First-time Patients Opt for Office-Based Buprenorphine

Patients starting buprenorphine treatment in a New Haven, Connecticut primary care clinic (PCC) are more likely to be new to treatment than those beginning methadone at an opioid treatment program (OTP), report Dr. Lynn Sullivan and colleagues at Yale University School of Medicine. The findings suggest that compared with methadone, office-based buprenorphine treatment attracts individuals who have less extensive addiction histories, are relatively healthier, and have more socioeconomic resources.

The investigators compared 96 patients entering a clinical trial of buprenorphine/ naloxone in a PCC with 94 participants entering a local OTP. Fifty-four percent of PCC patients were new to treatment, compared with 39 percent of those in the OTP. Among PCC patients, treatment novices were younger and more likely to be White than peers with prior methadone treatment. PCC patients reported fewer years of opioid addiction (10 versus 15, on average), lower rates of injection drug use (44 versus 60 percent), and less hepatitis C (25 versus 61 percent).

Three-fourths of PCC patients versus half of OTP participants were male, and more PCC patients were employed full-time (46 versus 15 percent). Consistent with prior research, methadone history did not affect treatment retention or abstinence rates attained with buprenorphine.